Social care: the public service alternative

Submitted by AWL on 1 December, 2021 - 10:04 Author: Mohan Sen
Care and Support Workers Organise

Really the only good thing about the Tories’ proposals for social care funding is that they are so blatantly not a solution to anything. The door is still open wide, perhaps now even wider, for a labour movement push for a real alternative on this crucial issue, shifting the debate, winning concessions and damaging the government in the process. But at the moment the push is far too weak.

Our minimum alternative should be to make social care and support provision a publicly-owned, publicly-provided system, with enough public funding to ensure it is completely free, high quality and provides its workers with decent pay and conditions.

In 2011 a commission led by establishment economist Andrew Dilnot recommended a life-time cap of £35,000 on social care costs paid by individuals.

After a decade of doing nothing but cutting public funding for care, the Tories have now announced a cap of £86,000. £35,000 in 2011, adjusted for inflation, would be £45,000 today.

People with assets of less than £100,000 will receive means-tested support.

Guidance from the Department of Health and Social Care (DHSC) also makes clear that only the amount contributed personally — and not any public contribution — will count towards the cap. Given the very high costs of care, many poorer people will still pay the same £86,000 as much richer people.

As Torsten Bell of the broadly right-wing Labour but generally thoughtful and informative Resolution Foundation put it: “If you own a £1m house… over 90% of your assets are protected. If you’ve got a terraced house in Hartlepool (worth £70k) you can lose almost everything.”

Even Dilnot and similar figures have expressed dismay at this disastrous stipulation.

However, yet another dire aspect of the policy comes straight from Dilnot’s original recommendations. The DHSC guidance makes clear that the cap only covers care itself. “Daily living costs” will be excluded and set at a nationwide flat rate of £200 a week. So accommodation etc. for someone in care for five years will come to more than £50,000.

In terms of overall cost, some people will benefit from the changes the government is introducing — but mainly the relatively well-off. (The genuinely rich and the capitalist class, of course, have no worries, easily affording lavish care whenever they need it.)

In terms of other urgent issues in social care, the policy does nothing. Care and support services will remain desperately underfunded. The government claims that its regressive “health and social care levy”, making workers pay through national insurance, will raise £10-12 billion a year. The conservative Institute for Fiscal Studies say it may be more like half that. In any case, only a sixth is earmarked for social care, in a period when demand and costs in the sector are rising sharply.

The policy does nothing to address the terrible terms and conditions of most care and support workers, and many other consequences of a comprehensively privatised and radically fragmented sector.

The only real alternative is the one demanded by Labour Party conference, by many unions and by the cross-union care and support workers’ network CaSWO! — for the transformation of the whole sector into a free public service, with public funding to abolish all charges and raise service standard and workers’ pay, terms and conditions. Social care should be aligned with the NHS as a free, publicly funded service and its workforce immediately elevated to directly employed NHS terms and conditions. (Ill thought-through and probably harmful suggestions of “integrating” the NHS and care are another matter.)

Socialists, trade unionists and Labour Party activists must do everything we can to boost care workers’ organising and struggles. We must challenge the Labour leadership over its bizarre failure to propose pretty much any alternative to the Tories’ catastrophic plans, and our union leaderships over their failure to even speak up and exert pressure, let alone organise a serious campaign. On that basis we should advocate the cohering of a broad labour movement campaign for transforming social care.

• CASWO’s demands
• More on social care here

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